Maryland’s billing landscape splits cleanly in two. Fee-for-service Medical Assistance allows 12 months from the date of service — but the HealthChoice managed care program, which covers the large majority of beneficiaries, enforces 180 days. Most Maryland practices live in the 180-day world whether they realize it or not.
Medical Billing Services Group supports Maryland practices remotely, with a US-based team working inside your existing systems. We serve practices in all 50 states from a single remote operation, and Maryland accounts get FFS and HealthChoice calendars tracked separately from day one.
Maryland Medical Assistance billing essentials
Maryland Medicaid operates as the Medical Assistance Program under the Maryland Department of Health. The rules that shape your workflow:
Fee-for-service: 12 months. A clean claim must reach the Medical Assistance Program within 12 months of the date of service (date of discharge for acute hospitals). Corrected claims need the original remittance advice as proof of timely submission and must arrive within 60 days of the last rejection.
HealthChoice MCOs: 180 days. Managed care claims must be received within 180 days of service. Plans like MedStar Family Choice deny anything later as untimely, and for COB claims the 180 days run from the primary payer’s explanation of payment — with the EOP required as an attachment.
Medicare crossover: 120 days. When Medicare is primary, the claim must reach Medical Assistance within 120 days of the Medicare EOMB date. Past 12 months from service, documentation must be attached or the system auto-rejects.
The practical takeaway: Maryland’s generous-sounding 12-month FFS rule rarely governs real-world billing. The 180-day MCO clock does.
Where Maryland practices lose revenue
Billing the MCO as FFS (and vice versa). If the recipient is enrolled in an MCO on the date of service, the MCO must be billed directly. FFS claims for MCO-enrolled patients deny outright. Eligibility verification has to identify HealthChoice enrollment and the specific MCO.
The 180-day MCO wall. Practices that internalize the 12-month FFS number get caught by the 180-day MCO deadline. After 180 days, the claim is denied as untimely and not paid — no appeal on the merits.
Crossover documentation. The 120-day Medicare crossover window is workable, but Maryland requires the EOMB attached and rejects claims past 12 months from service without documentation. Crossover claims need their own tracking, not a spot in the general queue.
Proof-of-filing standards. Maryland is strict about what counts as proof of timely filing: remittance advice, EOB, retro-eligibility letter, or a date-stamped returned claim. Billing system printouts don’t qualify — a fact that bites practices during disputes.
How MBSG supports Maryland practices
We provide full medical billing services and revenue cycle management for Maryland practices, including:
- Medical Assistance and HealthChoice claims submission — clean claims routed to the correct payer, tracked against 12-month FFS and 180-day MCO calendars separately.
- Denial management — root-cause analysis with corrected-claim workflows built around Maryland’s 60-day resubmission rule.
- Eligibility verification and prior authorization — MCO-level eligibility checks that prevent wrong-payer denials.
- Credentialing and payer enrollment — Maryland Medical Assistance and HealthChoice plan enrollment and revalidation.
- Medical billing audits — coding reviews targeting Maryland’s most frequent denial reasons.
- Clearinghouse connectivity — electronic submission with acceptance reports that meet Maryland’s proof-of-filing standards.
Smaller Maryland practices can use our small-practice billing support. Evaluating a change? See outsourced medical billing.
Specialties we serve in Maryland
Billing adapts to specialty coding rules — including behavioral health, cardiology, gastroenterology, oncology, pediatrics, internal medicine, OB-GYN, orthopedic, and urology. Browse all specialties and our services.
Get a Free Billing Audit.
If 180-day misses, wrong-payer denials, or crossover backlogs are costing your Maryland practice, start with a Free Billing Audit. We review recent claims and show you exactly where revenue is leaking.
Call +1 (307) 396-4107 or email contact@medicalbillingservicesgroup.com. Pricing is quoted in your written proposal after we review your volume and payer mix — see medical billing pricing. Data is handled under our HIPAA safeguards and business associate agreement (HIPAA & security).
Frequently asked questions
What is the Maryland Medicaid timely filing limit?
12 months from the date of service for fee-for-service; 180 days for HealthChoice managed care plans. Medicare crossover claims get 120 days from the Medicare EOMB. (Confirm against current Maryland Department of Health manuals; rules change.)
Does MBSG have a Maryland office?
No. We are a remote company serving all 50 states, working inside your existing EHR and practice management system.
How do you handle the FFS-versus-HealthChoice split?
Eligibility verification identifies HealthChoice enrollment and the specific MCO at the visit, claims route to the correct payer, and each deadline is tracked separately.
What counts as proof of timely filing in Maryland?
Remittance advice, EOB, retro-eligibility letters, or date-stamped returned claims. We keep clearinghouse acceptance reports on every submission.
Can you help with Maryland Medical Assistance enrollment?
Yes — credentialing and payer enrollment covers program enrollment and HealthChoice plan contracting.
How do we start?
Get a Free Billing Audit. We analyze your recent claims and denial patterns before you commit to anything.
General educational information, not legal advice or a guarantee of reimbursement. Requirements vary by payer, plan, setting and date of service. Coding references last reviewed 2026-10-08.